EMBRACING MY INSECURITIES: Endometriosis

Monica is a typical alpha female, strong and ambitious. She is a wife and a mother to an adopted son, but that doesn’t stop her from having a great career. She doesn’t believe women should be subjected to the kitchen and the “other room”, she believes in the advocacy for women’s rights on the ground of equality of the sexes. Her friends would say to her, “You know you can be rather intimidating at times, right…?”, and she always replied with a laugh and a wink – “Sometimes you have to be a beast to be taken seriously!” Nothing seemed to break Monica, physically, mentally or emotionally. Or so people thought…

But around the same time, usually a week or two before her period starts, her ‘monthly trouble’ would come. She would start to experience awful cramps in the lower part of her abdomen, and become depressed (even though she did a pretty good job of hiding it). The onset of cramps meant that Mother Nature was around the corner with another menstrual period, bringing with it a more intense pain which was so terrible that she always thought of it as being indescribable.

Sometimes she would lock herself up in the bathroom, totally unable to do anything, exhausted from throwing up repeatedly because of severe pain, and just assume a fetal position, sobbing on the bathroom floor. Nothing ever seemed to help ease the pain, in spite of taking all sorts of pain medications. The pain would radiate to her lower back and sometimes down her thighs, “Why does this happen to me all the time?!” she would cry, but, determined to avoid being seen as “weak”, she would always keep it to herself. After all, it was just menstrual periods, and periods are supposed to be painful. It was part of being a woman.

Even intercourse was painful; sometimes she would pretend everything was okay and bear it, on other days she would make excuses that she was tired from work or had a target to meet. “How are we supposed to start a family if we don’t have regular intercourse?” her husband would often complain.

“We have a child already” she would reply, and her husband would let it be, muttering to himself “But it’s not the same…”, too embarrassed to even say it out loud, because he loved his son just as much as he would if he were his very own.

And so one day she had to attend a program at work, organized to mark International Women’s Day. Since she wasn’t really interested, she took out her iPad and began to focus on ‘more important things’. She was oblivious to what the speaker was saying until she faintly began to hear words that sounded like he was reading a page from her diary, “… severe lower abdominal pain before, during, and even after menstruation, stooling or constipation before, during, or after menstruation, pain that radiates down to the thighs, painful intercourse, infertility…” the speaker went on to list basically everything Monica experienced. She was shocked and began to pay serious attention, hanging on to every word as if it were gold, and listening closely till the end of his presentation. “So let us speak up and raise more awareness of this chronic disease which affects an estimated 176 million women worldwide but too often still goes undiagnosed and untreated…” And then she suddenly realized that she was not alone in this. “Endometriosis?” she more or less asked herself… “It has a name?”, “It’s actually a thing?”

Monica smiled, teary eyed, because for the first time in a long time, she was began to feel that there was hope…

Endometriosis is an often painful disorder in which the lining of the inside of the uterus (which is shed monthly during a period) — called the endometrium — is found growing outside the uterus. It most commonly involves the ovaries, Fallopian tubes and the areas around the pelvis like the intestines. Rarely, endometrial tissue may spread beyond pelvic organs and be found in places like the lungs

The most common symptom of endometriosis is pain (before, during and/or after periods), which is usually severe enough to prevent one from going about regular activities and affect the quality of life. The most common complication of endometriosis is infertility.

The first suggestion of a diagnosis of endometriosis is from the complaints alone, if one has the classic symptoms of severe cyclical pain. The gold standard for making a diagnosis is to have a laparoscopy – a surgical procedure in which thin, rod-like instruments are introduced into the abdomen through small cuts. A camera is attached to them and the images are projected on a screen. This way, the pelvis and abdomen can be seen directly and areas of endometriosis identified. Non-surgical treatment options include:

The use of pain medications

Hormonal contraceptives: This is not a permanent treatment, as normal menstruation resumes and the symptoms start again in most cases when the medication is stopped.

GnRH agonists: This is a type of hormonal medication. The drug acts by preventing the body from producing estrogen, thus causing menstruation to cease. It is usually more effective than the hormonal contraceptives, but is also not permanent. However, it provides relief for longer periods after it has been stopped and menstruation resumes.

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